Ask the Expert: How to Ensure ICD-10 Success

Wednesday, August 12th, 12 p.m. ET

The October 1 deadline is nearly here, and if your practice isn’t prepared for ICD-10, your cash flow could take a serious hit. In this free webinar, our resident ICD-10 expert will help you assess your practice’s readiness, and discuss crucial strategies to ensure you thrive through the transition.

ICD-10 is less than 4 months away. Not only do you need to know how ICD-10 will impact your practice, but it is also critical to understand how to plan readiness with other vendors and payers that impact your organizations success. Without a proactive plan for readiness and risk mitigation, your practice could be facing a difficult and costly transition. So how can you tell if you’re on the right track?Continue reading: Webinar- Your ICD-10 Checklist: Getting Ready for October 1

The ICD-10 compliance date of October 1, 2014 draws nearer every day. While many individuals in healthcare believe this initiative to impact only coders and billing staff, that misconception will certainly prove detrimental on many levels. All involved in the patient care experience will be impacted, even the patient (as introduced in ICD-10: Ignorance is Not Bliss – Part 1.) In Part 2 of this 4 part series, we will continue to follow our patient through her post-ICD-10 experience. When we last left off, Doris Jones was waiting for an exorbitant amount of time in the clinic waiting room to see her doctor. After an hour, she is finally checked in and called back by the Medical Assistant.

By now, most individuals working in Healthcare have heard of ICD-10. The varying degrees of familiarity with the new diagnostic and procedure code set are as varied as the individual reactions to its upcoming required implementation. Some individuals shudder in fear as the diagnosis codes leap from ~13,000 codes in ICD-9 to ~60,000 in ICD-10 (not to mention the ~76,000 procedure codes that will now be required for use in the Inpatient environment.) Some individuals (certainly most coders and billers) can not sleep at night knowing the learning curve, productivity slowdown, and likely revenue loss that this initiative will certainly yield. Perhaps most disturbing, however, is that many individuals (including providers) believe that ICD-10 will not have an impact on their staff, their work, their finances, or the patient experience.

That, unfortunately, is a scary and fallacious understanding of what is ahead. ICD-10 will impact everyone. To make the point, I offer an example of a basic patient office visit.

The title of this article seems reasonable and appropriate. Unfortunately, it is patently false!

By now you are probably likely acclimated to (perhaps even enjoying!) the ‘touch once’ method of encounter documentation, in which you dictate, click and/or type through patient visit documentation. Once the patient leaves the office, you are 100% done with the documentation. Although this may not always be possible, this serves as the preferred method to complete your charting.

With the impending changes that ICD-10 will bring, you are all but assured of the requirement to re-touch a large number of your charts if you have not been properly trained in the methodology of ICD-10 billing.

ICD-10 looms over Healthcare in America ominously. Many studies project that a tremendous number of ambulatory medical practices will have very significant cash flow shortfalls . Many of them actually may declare bankruptcy, because of the draconian changes in the required billing processes on October 1st, 2014. A number of sources of information, including the Federal government at CMS, as seen at http://www.cms.gov/Medicare/Coding/ICD10/Downloads/ICD10SmallMediumChecklistTimeline.pd encourage immediate action!

Don’t get caught short. Arm yourself with the knowledge that will prove vital to your practice. Just as it took a year to learn anatomy, it will take your office a year to undertake the painful migration to using ICD-10 for all of your billing. To state the obvious, if you are not using ICD-10 for all medical services on or after October 1st, 2014, you will not be paid!

To state the less obvious, this is not an issue only for your billing department. You, the physician, will need to either:

You’ve just been through the nightmarish attestation process for Meaningful Use Stage I and Stage II. Perhaps, you have even received the sought after Federal stimulus dollars. Even worse, you’ve struggled through the transition to become a meaningful user of a certified Electronic Health Record, but you haven’t quite caught up yet. You purchased the wrong system at first and are migrating from one system to another. Sadly, this is an extraordinarily frequent problem.

You deserve a break. Unfortunately, with upcoming compliance initiatives , shifting government policies, and Meaningful Use Stage III right around the corner, this can not be so. Now comes an equally daunting task, and one which puts your entire practice’s finances at even more risk than did the migration to an EHR.

As you probably have heard, you will not be paid for any medical services that are provided on or after October 1st, 2014, unless you bill for them using the ICD-10 code set.